Abstract

The band 3 molecule is an anion channel for bicarbonate in the erythrocyte’s membrane that assumes a different role in senescent erythrocytes where it adopts a cluster configuration. These band 3 clusters expose previously hidden antigenic adhesive peptides which are recognized by natural band 3 antibodies that label their erythrocytes for reticuloendothelial elimination and prevent their endothelial adhesion. The sickle erythrocyte’s abnormal hemoglobin molecules cause them to experience premature senescence resulting in increased numbers of clusters, a portion of which remain uncloaked by antibodies and adhere to the vascular endothelium. The uncloaked clusters result from a deficiency of band 3 antibodies that are present in sickle cell anemia. The hypothesis presented is that the band 3 antibodies are insufficient in number to cloak all of the adhesive peptides present on cluster+ sickle erythrocytes and this is responsible for a portion of their adhesive pathology